Sleep-disordered breathing and childhood asthma

Abstract

Asthma morbidity in children remains high despite comprehensive evidence-based guidelines for evaluation and treatment. The objective of this review is to examine the evidence that obstructive sleep-disordered breathing often co-exists with asthma and is associated with asthma severity, and to discuss the clinical implications of this relationship, focusing particularly on studies published within the past year. Obstructive sleep-disordered breathing is highly prevalent in children with severe or poorly controlled asthma. Data from an observational study suggest that adenotonsillectomy markedly improves asthma outcomes in children with poorly controlled asthma and comorbid obstructive sleep apnea. Clinicians should consider evaluating and treating obstructive sleep-disordered breathing in children with severe or difficult-to-control asthma. Further controlled studies are needed to confirm that treatment of obstructive sleep apnea improves pediatric asthma outcomes, and to extend our understanding of how asthma and sleep-disordered breathing interact.